Running The United States of Running

Why You Keep Getting Running Injuries (and How To Avoid Them)

Photo: W+G Creative
We've all been there. You're training for a new race and everything is going well. The miles are getting ticked off and you are running more than ever. You feel great! And then suddenly it happens: You get an injury.

You rest and start to feel better, so you try running again. But then a few weeks down the line, you are injured again. You try supplements, massages, oils, and nothing seems to work.

You’re not alone. A study in Sports Medicine found that almost 85 percent of novice runners experience injuries. And on average, 50 percent of runners get an injury each year that's serious enough to prevent them from running, while 25 percent of runners are injured at any given time.

That’s a lot of injuries! Why does this happen? And, maybe more to the point, is there any way to avoid it?

The most common running injuries

Although runners may occasionally tear a tendon or break a toe (as I did in an ultramarathon recently), these types of traumatic injuries are actually rare. What’s far more common: chronic injuries that creep up over time.

A systematic review of running-related injuries published in the Journal of Sport and Health Science identified the five most prevalent injuries: The top one was patellofemoral pain syndrome, more commonly known as runner's knee, which causes pain beneath the kneecap. The second most common injury was medial tibial stress syndrome, or shin splints. Third place was tied between plantar fasciitis and iliotibial band syndrome (my personal nemesis), with the final spot going to Achilles tendinopathy.

What makes running injuries so prevalent?

One reason you come across so many injured runners is because they often rack up too many miles too soon—particularly when training for a big event—without giving their body enough time to recover and adapt. "In reality, there are so many different factors which could cause injuries but one common one is load management and progression," says chartered physiotherapist Nathan Liddle who is conducting a PhD study on running injuries.

Too much intensity, such as multiple speed work or hill rep sessions in a week, can have a similar impact. "If the body isn’t prepared for the added intensity and demands of the workout, injuries will happen," says running coach Louis Barnes.

Runners need to take into account all forms of exercise they’re doing, including gym work, cross training, and general time spent on their feet. Because even if you’re mixing it up, you might not be giving your body enough recovery.

Another major cause of injuries is a lack of strength training and conditioning, particularly on the lower limbs.

"People take up running because it is free and easy to do, but they haven't prepared the body,” says Liddle. “If you have just three hours a week free, you just go and do three runs and don't want do anything extra.” That can leave certain muscles weak, and others overworked, causing imbalances that throw things out of whack.

So…how can I avoid injury?

1. Keep your mileage and intensity manageable

The first thing to consider is the amount of times you are running in a week, and how far and how hard. Volume and intensity should be gradually increased, and allow time for recovery between runs.

You’ll often hear people cite the 10 percent rule, which just means increasing your mileage by no more than 10 percent each week. It can be a good general guideline to follow, but it isn’t based on scientific research. It’s also a little oversimplified: You could probably get away with bigger increases if you’re running lower mileage, like if you’re training for a 10K.

Instead, it can be more effective to listen to your body and respond accordingly. Increase mileage slowly, and every fourth or fifth week, drop to a much lower volume so you can recover.

When it comes to intensity, most coaches do agree on the 80/20 rule: Do 80 percent of your weekly runs at an easy pace where you can hold a conversation, and 20 percent at a hard effort when you cannot speak.

If you are unsure, then seek the advice of a running coach who can create a bespoke plan for your personal circumstances and goals.

2. Don’t *just* run

The type and amount of strength work you need to do is highly individual. You don't want to overdo it because this could actually lead to injuries itself. Begin with 15 minutes once or twice a week, and start with just body weight before progressing to weights. Focus on running-specific exercises like squats, bridges, and calf raises.

Try this Pilates series to target those running muscles:

Cross training with other aerobic activities is also an excellent way to maintain fitness while giving overused muscles and joints a break, or to replace a missed run. "To reduce the impact of running, mix things up by cycling, swimming, and using an elliptical machine,” says Barnes. “These are all great alternative cardio work and will work other muscles to complement your running.”

3. Give your body the essentials it needs to stay healthy

Other factors to consider are getting a good night's sleep to aid recovery and eating healthily. Just don't obsess about your shoes. "Runners put too much emphasis on footwear,” says Liddle. “There is no strong evidence when it comes to the impact of footwear on reducing injury risk.” Although it’s tempting to think you could fix everything by finding the right pair, really the answer is finding the right routine for your body.

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